Urinary Incontinence in the Elderly : Stress, Urgency, Overflow, Functional

Urinary Incontinence in the Elderly : Stress, Urgency, Overflow, Functional

Urology Nursing  

There are several clinical categories on the urinary incontinence. Let us consider one by one.


Stress urinary incontinence

Maybe you've come across people who when laughing or coughing followed by discharge of urine, either a little or a lot. Generally, the incident caused by the weakening of the muscles in the pelvic floor.

Although not the sole cause, but the frequency of occurrence of urinary incontinence due to a weakening of the pelvic muscles. This category incontinence usually occurs in the elderly who are aged in their 70s and often suffered by women.


Urgency urinary incontinence

Some of the neurological problems associated with urinary urgency incontinence, such as dementia, Parkinson's disease, stroke, or spinal cord injury. That occurs in this type of urinary incontinence is the patient complained of insufficient time to get to the toilet, but the urine was out first.

The process is very fast between the desire to urinate and the urine before patients are in the bathroom. This type usually occurs in old age people, over 70s.


Overflow urinary incontinence

Perhaps this type of incontinence rather rare. Uncontrolled urine that comes out in this type of incontinence is associated with the occurrence of prostate enlargement or multiple sclerosis, which can cause the patient to contract the bladder.

Factor drugs can also cause this overflow incontinence. How it happened? Patients who suffer from overflow incontinence is usually only a few passing urine without feeling the sensation when her bladder is full.


Functional urinary incontinence

For this type, mostly occurs due to severe dementia, environmental factors, and psychological factors. In patients who suffer from this type of incontinence is usually accompanied by the emergence of a variety of symptoms and urodynamic picture of the occurrence of more than one type of urinary incontinence.

Urinary Retention in Pregnancy

Urinary Retention in Pregnancy

Urology Nursing  

Uterine incarceration is a fairly rare occurrence with an incidence of only about 1 : 3000 pregnancies. Caused by uterine retroversion him, trapped behind the sacral promontory and fixed for the remainder of the pregnancy. Between 12-20 weeks gestation, the patient will complain of lower abdominal pain, constipation, urinary incontinence, urinary retention, or even urinate constantly.

Fernandes et al (2012) noted in 10 years at a hospital in Boston occurred eight cases of uterine incarceration. The risk is spontaneous abortion. In some severe cases, the uterus may interfere with the attitude of the bladder and rectum, so as causing rupture of the bladder and rectum gangrene.

Incarceration of the uterus can lead to misdiagnosis as ectopic pregnancy, the uterus is experiencing retroflexi part, presumed gestational sac cul - de -sac while the inferior part of the uterine endometrium unexpectedly empty. Ultrasound will show that the length of the cervix appears anterosuperior position. Fundus will be in the posterior, located next to the pelvic cavity.

In a journal written on J Ultrasound Med 2012; 31:645-50, Fernandes et al revealed that the repositioning of the uterus during pregnancy should be done between 14-20 weeks old. The patient was placed with the dorsal lithotomy position, then paired urinary catheter, and hand pressed bimanually the uterus. One finger went into the rectum, and then increase the pressure on the uterus. If difficult to do with regional anesthesia, this procedure can be performed laparoscopically or even laparotomy. Having returned to the position anteflexi uterus, uterine pessarium fitted for a week in order not to go back into retroversion.